The invention relates to a risk management system for use in a health care delivery environment.
In response to the increasing costs of providing medical care and the growing risks of expensive medical malpractice litigation, risk management has grown in importance to hospital administrators, often accounting for a sizable commitment of hospital resources to achieve its objectives. In general, hospital personnel responsible for risk management programs have two primary objectives. One of their objectives is to identify those areas of greatest exposure for the hospital due to, among other things, a real risk of actual medical malpractice or the lack of procedures or evidence of having followed procedures that would satisfy a reasonable standard of due care such as might be required to provide an adequate defense against a groundless malpractice claim. The other objective follows from the first. It is to implement those changes in hospital practice or procedures which will reduce the hospital's exposure, beginning with the areas of greatest exposure. The changes may involve, for example, taking steps to make sure that actual medical malpractice does not occur or even just making sure that adherence to acceptable standards of due care has taken place and can be proven.
The importance of such risk management programs is particularly recognized by the insurance carriers who insure the hospital against financial losses due to such exposure. It is generally the insurance carrier that must pay the high expenses of malpractice litigation, regardless of whether the claim is actually justified or ultimately proves to be groundless. It is also the insurance carrier which pays the judgements that arise out of such litigation. Predictably, the premiums which the hospital pays to its medical malpractice carrier reflects the amount of exposure the hospital has to such claims. And, not surprisingly, the level of those premiums often depends very much on the seriousness with which the hospital takes its risk management responsibilities.